LOW BACK PAIN AND ITS MANAGEMENT

Lowback pain

One of the most stressed area in sports. Its felt in the lumbar area. It can be subjected to acute and chronic stress .Low back pain can be aggregated by different factors. Inadequate strength, flexibility, reduced level of muscular endurance, congenital abnormalities and poor posture.

Causes of lowerback pain

1)    Mechanical

2)    Discogenic

Mechanical causes

1. Contusion, sprain and strain

2. Spondylolysis

Fracture occurring near to the articular process.  This can occur on both sides of the vertebrae  

3. Spondylolisthesis-

One vertebra can be slip forward or backward. It results in severe back ache. ( it can occur to gymnasts and weight lifters, fosbury flop, cricketers) It can also occur as a stress fracture.

4. Mechanical congenital problem- spinabifida

This condition occurs due to defect on growth where spinious process does not join in the mid line. Therefore  no bony protection at the back of the vertebrae. Gap is filled with  ligaments and fibrous tissue. These people will have a higher incidence of low back pain

Discogenic causes

Function of disc is to absorb the shock. Inter vertebral disc lies between adjacent vertebra and   behind disc spinal cord and nerves are situated.  If part of the disc fer squeezed out condition is called disc prolapse. It will press on spinal cord and nerves. This produces severe pain at the back and even in the legs. A disc injury can present in different ways.

Foot and leg problems

One short leg or deformity of one foot produces change in the back posture.

1.  1   Sudden onset

Occurs in weight lifting, wrestling or other twisting movements and pain spread from low back to legs. Coughing and sneezing will increase the pain

2.  2   Second injury

Occurs to the person who had recovered from back injury.Incidents like turning around or bending knee can bring a severe pain

3.   3  Pain in the legs only `

There may not back pain.  Its due to the pressure on the nerves to the lower extrimities

Prevention of low back pain

It can be prevented if spine  allowed to function normally . athlete experience  lower back ache due to , inadequate strength, insufficient flexibility, wrong techniques. Poor Standing posture, poor sitting posture and poor lifting techniques and sleeping causes. All these factors should be manged properly to prevent low back pain.

Rehabilitation of the low back pain

In the rehabilitation process the following points are to be taken care of

1.     A normal curve of the back should be maintained

2.     Muscle balance around the back area.

3.     Position of the pelvis will determine the posture of the spine . abdominal muscle play a major role in pelvic position 

4.     Flexibility of hamstring , psoas, Achilles will also determine the  position of the pelvis

Rehabilitation –stage 1

Person must not have pain on flexion of the spine . There should not be muscle spasm.

Exercises

1.     Person lying supine , bend one knee and pull the knee towards chest

2.     Lying supine bend both knees pulling towards the chest

3.     Rock and roll

4.     Half sit ups or quad sit ups

5.     Curl up.

6.     Pelvic tilt exercise- lie supine , knees bend .Roll up a sheet or thick towel under lumbar spine . Ask the person to press  the back on to the towel . Athlete must not lift the head or the buttocks while performing the exercises.

7.     Bridging exercises

8.     Stretching exercises for groin , psoas  muscle and hamstrings

Stage 2

All exercises in stage 1 can also be used in stage 2

1 .reverse curl up

2 .stand near a table with the feet on the floor . rest the trunk on to the table and extend one leg backwards with the knee straight.

Stage 3

Full sit ups

Stage 4

1. Oblique sit ups

2. V sit ups

3. Lower the trunk on to the table. Lift both legs backwards simultaneously.            It has to be done without any pain

4. Reverse curl up with straight knee.